Commercially insured members: 1-888-624-3096, Members covered through Medicaid plans: 1-800-711-5952, SHBP/SEHBP members: 1-800-414-SHBP (7427), Horizon Chat for Care may be available to some members at no cost through the companys free Horizon Blue app and. Information from Anthem for Care Providers about COVID-19 (Updated October 13, 2022). Here are some tips: Older adults, people with disabilities, and people with diabetes orwho have severe chronic medical conditions like heart, lung or kidney disease seem to be at higher risk for more serious COVID-19 illness. Increasing access to prescription medications. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. See how the Centers for Disease Control and Prevention (CDC) is closely monitoring the COVID-19 outbreak. Many thousands of people across the United States took part in research trials over many months. Reimbursement for COVID-19 testing performed in a participating hospital emergency room or inpatient setting is based on existing contractual rates inclusive of member cost share amounts waived by Anthem. What modifier is appropriate to waive member cost sharing for COVID-19 testing and visits related to testing? hb```e`` B@9 e'0w0i4bH) 3g2Ofaf~.j1* 30@vs10+|2 0 gV On April 30, 2020, we hosted a webinar to share information and resources with network providers regarding opportunities to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers. 24/7 access is provided at no cost. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. While a test sample cannot be obtained through a telehealth visit, the telehealth provider can help you get to a provider who can do so. No. CDC information for household members and caregivers can be found here. Symptoms can be mild to severe. Use of the Anthem websites constitutes your agreement with our Terms of Use. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Anthem will cover the administration of COVID-19 vaccines with no cost share for in- and out-of-network providers, during the national public health emergency, and providers are not permitted under the federal mandate to balance-bill members. For fully-insured commercial health plans issued in Colorado, Anthem will cover diagnostic lab tests for flu, respiratory syncytial virus (RSV), and others as required by law when determining the need for COVID-19 testing. In case of mass pandemic, how can you ensure that your contracted providers can still provide services? Anthems fully-insured commercial plans issued in Colorado cover telehealth as required by applicable law. In Connecticut: Anthem Health Plans, Inc. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. Providers do not need to notify Anthem of temporary addresses for providing healthcare services during the COVID-19 emergency. What financial assistance is available for care providers during the COVID-19 crisis? The Act expands existing federal loan programs, creates new tax credits, postpones employment tax payments, and includes additional tax relief. An airway and lung infection, similar to a cold. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Our actions are intended to support the protective measures taken across the country to help prevent the spread of COVID-19 and reduce barriers to seeing a doctor, getting tested and maintaining adherence to medications for long-term health issues. In compliance with California state law, some Anthem plans cover COVID-19 screening with no out-of-pocket costs. Need coverage now due to job loss? To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. The most common early symptoms appear between 2 and 14 days after being infected. Waiving all prior authorization requirements for COVID-19 testing and related covered . Serving California. Members can get their test covered at an in-network primary care physician or urgent care center or an in-network or out-of-network emergency room. Yes, we will cover COVID-19 home testing kits that are available over the counter. If an in-network provider is not reasonably available, the cost share waivers will include testing or screening for COVID-19 when received from an out-of-network provider. cdc.gov/coronavirus/2019-ncov/about/index.html. ET. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. Wash your hands often with soap and water for at least 20 seconds. Check out our frequently asked questions about COVID-19, our benefit changes, financial assistance and more. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. The State Health Benefits Program (SHBP) and School Employees Health Benefits Program (SEHBP) have also agreed to administer benefits consistent with these changes. Cost shares will be waived for in-network providers only. Our actions should reduce barriers to seeing a physician, getting tested and maintaining adherence to medications for long-term health issues. This applies to both diagnostic and screening tests. This modifier should be used for evaluation and testing services in any place of service including a physician's office, urgent care, ER or even drive-thru testing once available. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. COVID-19 diagnostic tests, including serology or antibody tests, and visits to get the test, for the duration of the public emergency. If you receive care from a doctor or healthcare provider not in your plan's network, your share of the costs may be higher. Your member ID card is your key to using your medical plan benefits. That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. Click below for the latest information for providers: The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced $20 billion in new funding for providers on the frontlines of the Novel Coronavirus (COVID-19) pandemic. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. cost sharing for visits where the purpose of the visit is to be screened and/or tested for COVID-19, regardless of whether test is administered, beginning March 18, 2020, for members of our employer-sponsored, individual, Medicare and Medicaid plans. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. If it doesnt, we can talk about your options. This is applicable for our employer-sponsored, individual, Medicare and Medicaid plan members. COVID-19 vaccines for youth toolkit available. COVID-19 testing and visits associated with COVID-19 testing. This modifier should be used for evaluation and testing services in any place of service including a physician's office, urgent care, ER or even drive-thru testing once available. Cost share waiver extends to the end of the public health emergency. Please discuss additional questions about COVID-19 treatments and medicines with your doctor. The Blue Cross name and symbol are registered marks of the Blue Cross Association 2023 Anthem Blue Cross. You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. Good health habits can also help prevent and fight COVID-19. The cost-sharing waiver includes copays, coinsurance and deductibles. Go to the main page on anthem.com/ca to log in and search for a doctor, or call the Member Services number on your ID card. Right now, medical experts think that COVID-19 spreads from person-to-person through a cough, sneeze or kiss. And let them know if youve been in close contact with a person known to have COVID-19, or if you live in or have recently traveled to an area where the virus has spread. After that time, standard Medicare and Medicare Supplement cost sharing and coverage will apply. Anthem will waive member cost shares for COVID-19 lab tests performed by participating and non-participating providers. We're here to make sure you have the resources and care you need to keep yourself safe and well. Anthems affiliated health plans are committed to help our members gain timely access to care and services in a way that places the least burden on the healthcare system. If you can't use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. Does Anthem require use of a contracted provider for the COVID-19 lab test in order for waiver of the members cost share to apply? We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. What codes would be appropriate to consider for a telehealth visit with a patient who wants to receive health guidance during the COVID-19 crisis? No, prior authorization is not required for diagnostic services related to COVID-19 testing. Are there any in-network or out-of-network limitations on these guidelines? The CDC has provided coding guidelines related to COVID-19: Error! This includes covered visits for mental health or substance use disorders and medical services, for our fully-insured employer plans, individual plans and Medicaid plans, where permissible. Telemedicine not only helps members get the care they need, but helps reduce the spread of the coronavirus protecting the health of our members and the doctors and nurses who care for them. This includes visits for behavioral health for our fully insured employer plans, individual and Medicaid plans, where permissible. When ordered by your doctor, testing, diagnosis and treatment for COVID-19 are available to Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) members withzero out-of-pocket costs. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. FEP will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications. An attending health care provider may order a test. Cover your cough or sneeze with a tissue, and throw away the tissue. Coronavirus is a type of virus that causes respiratory illness an infection of the airways and lungs. border-radius: 50%; Here is what the CDC recommends. Researchers from UNR Med, in partnership with the NV Department of Health and Human Services and Immunize NV, are conducting a survey to learn about the public's knowledge about the COVID-19 vaccines. However, to assist providers our COVID-19 Vaccination Roster Billing Form provides a default Z23 diagnosis code. Our clinical team is actively monitoring external queries and reports from the CDC to help us determine what action is necessary on our part. Wash your hands or use hand sanitizer when entering their house or room. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Hyperlink reference not valid. Other self-insured health plans are responsible for the specific plan designs they choose to offer to their employees, and we will continue to work with them to administer their plan designs as directed. Confusion; bluish lips or face; or unconsciousness. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. Wash your hands often with soap and water; use hand sanitizer when you cant wash. Clean and disinfect items and surfaces you touch often. Anthem Blue Cross and Blue Shield Healthcare Solutions waives cost share for COVID-19 treatment California Department of Public Health COVID-19 Updates, State of California Coronavirus (COVID-19) Response, (CDC) - People at Risk for Serious Illness from COVID-19, U.S. Department of State, Travel Advisories, World Health Organization (WHO), Coronavirus, Members with Cal MediConnect plans (Los Angeles County), Members with Cal MediConnect plans (Santa Clara County), vaccination prevents severe illness, hospitalizations, and death, cdc.gov/coronavirus/2019-ncov/about/index.html. The U.S. Department of Health and Human Services (HSS) announced the distribution of approximately $15 billion from the Provider Relief Fund to eligible providers who participate in state Medicaid and the Children's Health Insurance Program (CHIP): On June 9, 2020, the Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced additional distributions from the Provider Relief Fund to eligible Medicaid and Childrens Health Insurance Program (CHIP) providers who participate in state Medicaid and CHIP programs. As an Anthem member, you have access to a wide range of online resources to help you and your family members address emotional health and life challenges. Visit the CDC website for the most up-to-date testing guidance. Members can check their symptoms and connect with a doctor right from their phone. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. endstream endobj 112 0 obj <>/Metadata 8 0 R/Pages 109 0 R/StructTreeRoot 23 0 R/Type/Catalog/ViewerPreferences 133 0 R>> endobj 113 0 obj <>/MediaBox[0 0 612 792]/Parent 109 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 114 0 obj <>stream What can I do to keep from running out of medication? Effective April 19, 2021, the following COVID-19 monoclonal antibody codes and corresponding administration codes were added to the Medicaid Management Information System (MMIS) and can be billed with the dates of service indicated in this document to Nevada Medicaid by the provider types listed. Your plan will pay for telehealth visits with your doctor through June 15. You should try to see your PCP or a doctor in your plan. These actions are intended to support the protective measures taken across the country to help prevent the spread of COVID-19 and are central to the commitment of Anthems affiliated health plans to remove barriers for our members and support communities through this unprecedented time. Get the latest information on the COVID-19 vaccines. If you have employer coverage, or an individual or family plan, you can get over-the-counter COVID-19 tests for diagnosing COVID-19 through your BCBSIL/Prime Therapeutics pharmacy benefits. If you have questions about your COVID-19 benefits, please call the Member Services number on your ID card. hk%@Z^ pp>ZV]X~ fE#E2y$IFD*r\Rtk^u_e,~tIG*aJ*h'URWjRJ=W*L)CCCBTjJ4Oo~x|~y|?x~|.o._=w_~w_{?G=o1q}w?\ZNwuw?Kw|/vCyvIY7?}Ngw}&UG-&F-w_=_,_=aUq+uK[W--kVtkKU=V5|Zq:4o]{u\Z-UCC5PqiU#]Eyfk]WJnv?/u]s9n'#~rk]f2x7-,}_[-mjeh5j7 o~L}5wQVeu,OkA4oSS3.U Screening tests show whether or not someone has COVID-19. Individuals with Intellectual and Developmental Disabilities, Individuals with Mental Health and Substance Use Needs, Individuals Who Need Long-term Services and Support, U.S. Department of State China Travel Advisory, CDC, People at Risk for Serious Illness from COVID-19, Administration for Community Living, Coronavirus, CMS Press Release: President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak. We will waive cost sharing requirements for urgent care, telehealth and office visits to screen or determine whether COVID-19 testing is needed, when received from an in-network provider, or if no in-network provider is reasonably available, then from an out-of-network provider. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Please note that the following information applies to Anthem Blue Cross and Blue Shields (Anthem) Commercial health plans. Psych Huboffers resources to help with pandemic-related stress such as social isolation, coping with grief and loss, and other mental health issues. You can get 90-day supplies of most prescription medicines, depending on your plans pharmacy benefits. On December 11, 2020, the U.S. Food and Drug Administration (FDA) approved the Pfizer COVID-19 vaccine for individuals aged 16 years and older for emergency use authorization (EUA). There are no delivery charges for members who use Anthems Home Delivery Pharmacy. Today, unless otherwise required under state and federal mandates as detailed below, Anthem health plans will suspend select prior authorization (PA) requirements, member cost sharing, claims review and handling protocols to allow health care providers to focus on caring for patients diagnosed with COVID-19: We are committed to helping care providers learn how you can secure resources to support yourselves and your business during the COVID-19 crisis. Please log in and update your communication preferences to make sure you receive the latest information. Submit telehealth with the CPT code for the service rendered, place of service (POS) 02 or 10, and append either modifier 95 or GT. Member Discounts Take advantage of member-only discounts on health-related products and services. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. Pain or pressure in the chest that wont go away. As we announced on March 6, 2020, Anthem will waive cost shares for members of our fully-insured employer-sponsored, individual, Medicare, Medicaid and self-funded plan membersinclusive of copays, coinsurance and deductiblesfor COVID-19 test and visits to get the COVID-19 test. By continuing to use this website, you consent to these cookies. Member Discounts Take advantage of member-only discounts on health-related products and services. COVID-19 testing remains an important part of keeping our families and communities safe. You may also receive a bill for any charges not covered by your health plan. Effective March 17, 2020, through September 30, 2020, unless a longer period is required by law, Anthems affiliated health plans will waive member cost share for telehealth (video + audio) in-network visits, including visits for behavioral health, for our fully-insured employer plans and individual plans. No. Clean and disinfect items and surfaces you touch . The expansion covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020. If you cant use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is covered under certain conditions. When are COVID-19 tests covered? , coinsurance and deductibles and symbol are registered marks of the airways lungs! 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